Have a heart?

January 10, 2009 11:18 AM

How can I manage these chest pains? (Doctors say my heart is healthy)

I have chest pains all the time. My arm tingles as well. Over the course of a few years I've been in the ER as I thought I was having a heart attack only to be told "your heart is healthy, it must be stress." I've been to cardiologists and they say "you're heart is fine."

So I guess it's stress and I've got a few stresses affecting me. My wife and I are splitting up, I'm freelance and have to constantly scramble for work in this economic meltdown, I'm naturally an anxious person and my bank account is quickly dwindling.

I'm on anti depressant medicine and I'm doing marriage counseling and I don't ever really *feel* stressed out but my heart says otherwise. I'll be fine and then all of the sudden I feel like there is a very large suitcase on my chest and pains running up and down my arm.

My counselor says I need to see a psych and get some meds for it but I honestly can't afford a psych and more meds (I'm on a HSA and my deductable is 5k...something I don't have).

So what are some ways I can manage my heart pains? Some people have suggested meditation but I have the attention span of a squirrel and have trouble doing that (although I'm open to continue to try). Is there anything else?

As for my habits. I don't really exercise (I go for walks from time to time), I drink probably a little heavier than I should, I *love* my job although it barely gives me any income and while it's a helluva problem, my wife and I get along pretty well for two people splitting up.

So does the hive have any suggestions? I'm open to books, natural remedies, self talk and any other forms of help.

posted by Hands of Manos to health & fitness (19 comments total)

Get into exercise. Some kind of regular exercise and movement (and, dare I say, trying to drink less) will help your body relax. I used to get lots of stress related pains (even when I wasn't feeling particularly consciously stressed), and have found that a regular fitness routine has helped lots. Even if it's just a 20 minute walk after work every day, exercise will almost certainly help.
posted by shewhoeats at 11:41 AM on January 10

Please follow your counselor's suggestion to visit a psychiatrist for diagnosis and evaluation. If, after other physical causations have been ruled out by physicians, you are found to have panic attacks, there are many medications and treatment that might help you.

If cost is a concern, contact local teaching hospitals and medical schools in your area, for some offer low-cost rates for psychiatric evaluation. Additionally, consider revisiting the doc who prescribed or is refilling your antidepressant Rx. Does that physician know about your chest pain history? Could s/he evaluate you and prescribe accordingly?

Without proper diagnosis, you'll be treating symptoms without knowing their causation. At best, you'll feel better; at worst, you might accidentally exacerbate your condition.
posted by terranova at 11:42 AM on January 10

Yogurt and plenty of water. You might be experiencing an upset stomach that is causing acid reflux/gas buildup/heartburn/or an ulcer. You may not notice the acid coming up your throat all the time, or the gas buildup...but I'm willing to bet that with a healthy heart, your problem is beginning in the gut....and anxiety does wonders in making it worse :)

Also, make sure you're staying hydrated, drink plenty of water..and keep your vitamins/nutrition up. Take some time off, get some rest. I'd also consider getting a 2nd opinion on whether you need the anti-depressants if you you don't "feel" that you're stressed....no reason to add possible side effects they could cause.

A typical gas pain can go up as high as right below the collar bone, heartburn is often mistook for heart problems...thus the clever name. I'd research that angle a little more online to see if it matches your symptoms.
posted by samsara at 11:45 AM on January 10 [2 favorites has favorites]

This is entirely a non professional suggestion, but perhaps you can ask your doctor about prescribing a beta blocker. I assume you already have some anti-anxiety medication? This really sounds very much like panic attacks. Obviously exercise and diet and counseling are all important, but sometimes the meds are a good place to get a 'leg up'. The exercise can be as simple as walking a mile a day, you don't have to go gung ho... and if you can find some simple activity to relax with, such as gardening or model building, or fly fishing or knitting, you'll sort of become mediative in spite of your short attention span.
posted by dawson at 11:45 AM on January 10

You do need psychiatric help. I've had the same chest pains and only a few years of medication and treatment have helped ease them -- along with a lot of exercise, seeing a biofeedback trainer to learn how to control my breathing and "self-settle", and a bunch of other things.
posted by SpecialK at 11:47 AM on January 10

Yes, you need to start looking after your body. This is important at any age, but as you approach 40, it's all the more crucial (and I say this as someone north of that). Exercise, stretching, body work (such as massage and acupuncture). High intensity exercise is cathartic and will allow you to vent the pentup frustrations you're carrying around in your body and mind. For example, you could join a gym and hit the punching bag. Try a bikram yoga class. Go for a bike ride.

Loving your job is great, but if the stress of not earning enough is giving you a virtual heart attack, you need to reconsider whether it's a viable way of earning a living. Can you supplement it with something part time?
posted by computech_apolloniajames at 11:50 AM on January 10

Massage. Deep tissue. Once a week.
posted by orthogonality at 12:00 PM on January 10

My left hand tingling is the result of pinched nerves in my shoulder, and I get chest pains that turn out to be muscular. Both things are far worse if I don't get regularly vigorous movement and stretching. Does the job you love involve being semi-motionless at a desk for long periods? If so, you need to counterbalance that with something else that limbers you up. Such an activity will probably also reduce your stress levels, for that is part of the magic of exercise too.
posted by i_am_joe's_spleen at 12:31 PM on January 10

thanks guys. I'm a designer/illustrator, I sit at the computer all day. I suppose I could walk more...and maybe run a bit too
posted by Hands of Manos at 12:40 PM on January 10

You don't mention racing pulse or other specific cardiac symptoms - is it possible your chest pain is musculo-skeletal? I recently had a diagnosis of costochondritis and, as my doctor predicted, once I realized it wasn't my heart and stopped worrying about it, it mostly went away.
posted by judith at 1:13 PM on January 10

PS: you refer to this as your "heart pains", but if your doctors are correct, that is not what they are.

It so happens that my Dad has the real deal, and after talking to him, it's clear that what I feel is not the same, even though at a gross level ("tingling", "chest pain") it sounds as though it is. When you read stuff about chest pain, you will very likely be advised to get medical help straight away, because better safe than sorry, but that doesn't mean that every pain in your chest is in fact your heart.

It is pretty freaky to have chest pain and think shit! Is this a heart attack!? Am I going to die? Such thoughts are not going to help your stress levels.

Perhaps it would help if you can find someone you know who has had a heart attack and is prepared to talk about it?

PPS: if you don't get any exercise, that does actually put you at greater risk of eventually getting real heart disease. If you want to feel better about this prospect, taking some preventive steps like exercise and improving your diet would be a good way to deal with this anxiety.

PPPS: if your marriage is falling apart, this is an excellent time to develop some new habits and take care of yourself.
posted by i_am_joe's_spleen at 1:16 PM on January 10

How can I manage these chest pains?

Chest pain can be complicated and dangerous. Sounds like you still don't have a diagnosis.

No one with anything but placebo suggestions will touch this question with a 10 foot pole.
posted by gramcracker at 2:05 PM on January 10

Yoga, as a substitute for meditation. I have an extremely poor attention span too, but yoga, especially Ashtanga or power yoga, is similar enough to a workout that I don't get too bored, and yet when I'm done I feel more centered and relaxed in a way that's similar to what I believe I could experience from meditation if I could actually focus enough to meditate.
posted by hazyjane at 2:45 PM on January 10

Second terranova, talk to your MD. Benzos are dirt cheap, if you're prescribed one of those for panic attacks you are looking at $10-$20/mo tops. It's probably worth the investment of a few hundred bucks to get your life back.
posted by crazycanuck at 3:16 PM on January 10

I would look at refux, as some have suggested. You could try elevating the head of your bed at night to see if it's affecting your sleep.

Sometimes also those chest pains can be related to asthma-related inflammation.

I would also consider some type of massage and/or yoga. There have been times in my life that stress has pinched the nerves on my shoulders to the point where I was numb.
posted by answergrape at 3:21 PM on January 10

FWIW, I went to the emergency room last week due to serious chest pains and a numbish/twinging left arm. I had felt milder version of this a couple of years ago but figured they were due to me sitting sidewise, reaching over with my left arm across my body to reach the keyboard too much, but last week I could hardly move around and thought for sure this was the Real Deal.

EKG, x-ray, and blood test later and the emergency room doc said my self-diagnosis was correct, and two days later & some motrin the chest pains were gone.

Brachial plexus neuritis is the condition.
posted by troy at 5:42 PM on January 10

thanks guys. I'm a designer/illustrator, I sit at the computer all day. I suppose I could walk more...and maybe run a bit too

Walk first, then you can run. I don't run unless I can walk five miles or more, daily, without pain ... then again, I've got a bunch of physical health issues in my feet, knees, shins, and lower back.

While you're walking, briskly, try to find a kind of "centering place" by taking deep breaths and relaxing the muscles, starting with your limbic system (facial muscles) and then working your way down and out, ending with your feet and finger tips. (This is also a really good way to get to sleep, if you have problems with that.) Try and maintain a decent clip walking while focusing on being relaxed and calm and "one with the world" -- and specifically NOT thinking about any projects you have going on or anything else except the walk and how nice it is to be there. Sometimes, I'll walk my usual "loop" twice because it's just that nice to be out there.

If you drink alcohol, I'd stop for a little while. The ups and downs that alcohol can create can really worsen anxiety issues, even if it makes it "better" for a little bit.

Ativan, which is the drug most often prescribed for short-term crisis effects (i.e. chest pains due to anxiety), is exceptionally cheap and can be had for a month's supply for less than $10, even at an "expensive" (i.e. not walmart or kroger or another with a $4 drug list) pharmacy.
posted by SpecialK at 11:38 PM on January 10 [1 favorite has favorites]

Just as a point of information here, I had 'strange' feelings in my chest, in my heart, and I thought "I'm dying here, I'm having a heart attack" so I went to my doc and told him about it, he did a full exam (including EKG) and found nothing, sent me to Austin Heart Hospital, where they did as full an exam as they had at the time and found nothing, said it was in my head, etc and etc. Three or four years later I'm dead as Dillinger, massive heart attack(s), and it surely wasn't fun to go through all that jive, dying and then physical rehab blah blah blah, pain in the ass.

So unless these folks have really checked you out -- I think that today they'd maybe find the problem at Austin Heart Hospital, though maybe not, short of a dye test in real time -- unless you're sure that you're okay, don't take some mopes word on it. Doctors fuck up too, and their tests aren't be all end all, even in heart hospitals. I'm not saying that you definitely do have some problem, but you might -- I did. And I really got onboard with them, figured "Hey, I'm okay, I just THINK I'm dyiing and/or having a heart attack" and I DO sometimes have anxiety and HAVE had panic attacks that caused me chest pain. But what I was feeling then and which did kill me was the real deal.

Sorry to lay this on you here, I'd rather just get you a scrip for ativan (and you don't need to see a shrink to get that, any doc can write you for any drug, ativan isn't but a simple benzo) and you're on your way, and probably that's the case. But don't discount chest pain unless you've really been checked out, more than just those silly stress tests they put you on.
posted by dancestoblue at 9:49 PM on January 11

Ignores that pain. That is the best for you. If you have done all procedure like x-ray, EKG and others and the doctor said OK, so ignore that pain. That pain is just on your mind. Doctor said psychosomatic syndrome.
posted by Bob Royan at 7:22 PM on January 13